"Smoking is now the principal avoidable cause of premature deaths in Britain. Smoking hits worst off people hardest of all. Smoking is one of the principal causes of the health gap which leads to poorer people being ill more often and dying sooner." Frank Dobson.

The government is to make nicotine patches available on prescription to people on lower incomes.

The move is aimed at reducing the number of poor people smoking - the single biggest risk factor for cancer.

Health reports have shown that people on lower incomes are more likely to smoke and to get addicted to tobacco than the rich.

The patches currently cost around £15 a pack.

Health Secretary Frank Dobson told the House of Commons on Thursday that the government would invest £60m in "the first comprehensive" health programme to help people give up smoking.

He said seven out of 10 smokers wanted to quit.
The government's health programme includes:

free nicotine replacement therapy for people living in deprived Health Action Zones (HAZs)

health improvement programmes will aim to reduce smoking, especially in the worst-off areas.

The move to provide free nicotine replacement therapy to the poor has been backed by the British Medical Association (BMA), the Imperial Cancer Research Fund (ICRF) and health promotion experts.

The ICRF said nicotine replacement therapy was "a very cost-effective treatment". "Half the difference in death rates between rich and poor in the UK is caused by tobacco," it said.

However, the BMA expressed hopes that poor people outside the 27 HAZs will also benefit from free nicotine patches.

"There are more than 27 deprived areas in the country. The BMA would not like to see other imaginative smoking cessation programmes bureaucratically excluded or frustrated by lack of resources," it said.

A spokesman for the Health Education Authority, which will shortly be broadcasting a series of anti-smoking adverts specifically aimed at people on low incomes, said: "This is a good example that can ensure those in most need and those least able to afford nicotine patches are able to get them."

He said nicotine patches had been proven to double people's chances of being able to give up smoking.

However, he added that there were other factors that would influence whether people could give up, including motivation and willpower.

Health inequalities

A recent government-commissioned report on health inequalities prepared by Sir Donald Acheson, the former chief medical officer, showed that the poorer you are the more likely you are to smoke.

In 1996, 29% of men and 28% of women smoked, but only 2% of professional men and 11% of professional women smoked, compared with 41% of unskilled male workers and 36% of unskilled women workers.

Richer people also smoke fewer cigarettes than the poor, are less likely to be addicted to cigarettes and more able to give up smoking.

Since 1973, the number of rich people who stop smoking has doubled from 25% to 50%, although there is less of a gap between people in younger age groups.

Around 9% of poor people gave up smoking in 1973. That figure had only risen to around 13% in 1996.

Moreover, the number of people who smoke in the UK has fallen in recent years, but the number of poor people who smoke has remained stable.

The report says: "Smoking is an important component of differences in mortality between social classes."

Motivation

The spokesman for the HEA said: "People who are in tougher circumstances generally do not have the motivation required to give up.

Single mothers are twice as likely to smoke as the average person

"They see smoking as an essential part of life whereas people in higher income groups see it more as a hobby or a luxury.

"Poorer people are more likely to put money aside for cigarettes in the same way they would for the electricity meter.

The HEA recently funded a big research study into smoking among single parents which showed single mothers were twice as likely to smoke as the average person.

"They see it as a pleasure they can afford when they do not have much else," said the spokesman.

He added that self esteem and social factors were also involved.

The children of parents who smoke are three times more likely to follow suit.

If their elder brothers or sisters smoke, they are four times as likely to take up the habit.